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Abstract: PO2280

Perinatal Cystatin C as Biomarker of Nephron Endowment

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Crippa, Beatrice Letizia, NICU, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
  • Ghirardello, Stefano, NICU, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
  • Capone, Valentina, Pediatric Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
  • Ardissino, Gianluigi, Pediatric Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
Background

Nephron endowment has a wide individual variability and plays a crucial role in drug toxicity, outcome of kidney diseases and pathogenesis of arterial hypertension (AH), but nephrons count is technically impossible in vivo. During acute dehydration, subject with reduced nephron mass (unilateral renal agenesis or renal hypoplasia) exhibit increased levels of biomarkers of renal function compared to healthy subjects. We hypothesized that healthy newborns with reduced nephron endowment will have high levels of cystatin c (Cys-c) during perinatal dehydration. The aim of the study was to compare Cys-c level during physiological perinatal dehydration in healthy term infants with hypertensive fathers (HF) and normotensive fathers (NF).

Methods

Healthy, Caucasian, born at term neonates were enrolled: infants with fathers on antihypertensive therapy were compared to infants with normotensive fathers > 40 yo. Enrolled infants underwent Cys-c capillary determination at time of expanded newborn screening.

Results

We enrolled 40 infants with HF and 80 infants with NF. Basic characteristics were not different between the two groups except for the number of hypertensive grandparents, that was higher among infants with HF. Cys-c levels was determined at a median of 62.5 hours of life (IQR 55-71) without any difference between groups. Cys-c was significantly higher in infants with HF (1.6 ± 0.3 mg/L vs 1.4 ± 0.3 mg/L; p < 0.001), Linear regression analysis corrected for confounders (type of feeding, delivery mode, weight loss velocity) confirmed that paternal hypertension was the only variable significantly associated with high Cys-c level (mean difference 0.2 mg/L, IC 95% 0.1-0.3 in; p < 0.001).

Conclusion

Our results support the key role of nephron endowment in the pathogenesis of AH and suggest the possibility of identifying at-risk subjects at birth. This opportunity opens up specific and targeted preventive health measures very early in life.